[Relationship between clinopathological features and outcome of rituximab treatment for diffuse large B-cell lymphoma].
OBJECTIVE
To investigate the relationship of clinopathological features and outcome of rituximab treatment for diffuse large B-cell lymphoma (DLBCL).


METHODS
Sixty-nine patients with DLBCL received intravenous infusion of rituximab in combination with different chemotherapy regimens have been retrospectively analyzed. The influencing factors such as age, stage, serum level of lactate dehydrogenase (LDH) and bulky disease were analyzed retrospectively in terms of the response. The anti-/ pro-apoptosis proteins were detected by immunohistochemistry (SP methods). The correlation of protein expression with efficacy of rituximab treatment was also analyzed.


RESULTS
In the patients with previously untreated aggressive B-NHL, the combination of rituximab with chemotherapy achieved an overall response rate (ORR) of 90.7% and CR of 69.8%, while in the patients with relapsed disease, that was 80.8% (ORR) and 30.8% (CR). The disease stage (P = 0.046), serum lactate dehydrogenase (LDH) (P = 0.024), physical status (P = 0.009) and bulky disease (P = 0.013) were found to be unfavorable factors for the immunochemotherapy. The treatment efficacy in the patients with Bcl-2 overexpression was better than that in cases with negative one. No correlation of the bax and survivin expression with immunochemotherapy efficacy was observed.


CONCLUSIONS
The immunochemotherapy regimen (rituximab plus chemotherapy) can improve the response rate and CR rate without significant increase in toxicity in patients with diffuse large B-cell lymphoma. The advanced stage, high serum LDH level, relapsed disease, bulky disease and negative Bcl-2 expression are unfavorable factors affecting the therapeutic efficacy.
Zhang
Hong-Yu
HY
Department of Medical Oncology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, China.
Guan
Zhong-Zhen
ZZ
Wang
Bo
B
Huang
Hui-Qiang
HQ
Xia
Zhong-Jun
ZJ
Lin
Tong-Yu
TY
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins; D007770:L-Lactate Dehydrogenase / Q000097:blood; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008869:Microtubule-Associated Proteins / Q000378:metabolism; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011241:Prednisone / Q000627:therapeutic use; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D012074:Remission Induction; D012189:Retrospective Studies; D000069283:Rituximab; D015996:Survival Rate; D000077022:Survivin; D014750:Vincristine / Q000627:therapeutic use; D055815:Young Adult; D051028:bcl-2-Associated X Protein / Q000378:metabolism
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; C107489:BIRC5 protein, human; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D019253:Proto-Oncogene Proteins c-bcl-2; D000077022:Survivin; D051028:bcl-2-Associated X Protein; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D007770:L-Lactate Dehydrogenase; D011241:Prednisone